Addressing adolescent religious manifestations within medical decision-making

  • Adrienne Wong

Student thesis: Doctoral ThesisJD (Juris Doctor)


Under English law, minors under the age of 16 are presumed to lack the capacity to make their own medical decisions but can give valid consent to medical treatment if they are found to be Gillick competent (i.e., the possession of sufficient maturity, understanding, and intelligence to enable him or her to fully understand the treatment proposed). While it is clear that the right to consent is protected, questions remain as to whether the attainment of Gillick competency confers absolute rights to autonomy on all medical treatment. The extent to which a valid refusal is respected, particularly, a refusal to life-saving treatment, is heavily contested. Subsequent judicial developments in the 1990s diverged from the spirit of Gillick, securing the power of the courts and those with parental authority to override competent refusals if it appears that such refusals are not in the best interests of the minor.

This research project is concerned with the extent of judicial recognition of adolescent decisional autonomy, the adequacy of consideration of a child’s views and wishes, and whether sufficient respect is given to decisions made on religious grounds. This dissertation addresses two main questions: (1) Is there sufficient legal respect and protection towards a minor’s faith-based medical decisions and other personal views? (2) Does the legal imperative to interfere with a minor’s medical decisions also interfere with the protection of their decisional autonomy? By combining doctrinal and ethical analysis research approaches, this dissertation finds that the current law is overly paternalistic and neglects the importance of a child’s religious views as relevant factors towards their decision-making processes. This is attributed to the imposition of unattainable thresholds of capacity on minors, narrow interpretations of best interests, and insufficient consideration of the aftermath of treatment imposition on a child’s bodily integrity and dignity. The purpose of this dissertation is to critique the current law’s failings and ascertain whether future reform can further protect the decisional autonomy of minors.

Thesis embargoed until 31 December 2023.
Date of AwardDec 2021
Original languageEnglish
Awarding Institution
  • Queen's University Belfast
SupervisorGerard Kelly (Supervisor) & Clayton Ó Néill (Supervisor)


  • Medical law
  • medical ethics
  • Gillick competence
  • mental capacity
  • children's rights
  • children's participation
  • decisional autonomy
  • best interests
  • religion
  • Jehovah's Witnesses

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